Information Session Request

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EPIC INFORMATION SESSION REQUEST

What this form is for

This form can be used to make a request for EPIC to provide an information session about our services to young people, staff teams and foster carers at your organisation/centre etc

This session will be facilitated based on the availability of the advocate for your area.

Please complete the form fully. Fields marked with a * are required.

We will contact you as soon as possible after receipt of your form, thank you.

Your Name

First Name

Last Name

Service Name*

Please type service/organisation name

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Your Role/Job/Title (if applicable)

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email address*

Email Address

Phone

Location of Service*

Please type town name

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EIRCODE*

Please enter your 7 digit Eircode to help us find you

Not sure? Find your Eircode

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County*

Your TUSLA Region*

TUSLA is the Child and Family Agency - to help us provide support we need to know which TUSLA region you are in

No. of People Session is For*

Roughly how many people will be attending?

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Any other information or question?

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Thank You!

Please confirm you’re not a spam bot and that you agree to us processing your data. Then press SUBMIT to send your application.

We’ll send a copy to the email address you give.

EPIC Advocacy Team

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What this form is for

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